I dread watching films that depict therapy.
This ongoing blog frequently acknowledges the dearth of films that can be used in clinical mental health treatment. While there are very good – and even great – films released every month, few meet the requirements for inclusion in therapy. It is even rarer to find realistic depictions of mental health treatment in cinema. This is both troubling and problematic; a decision to procrastinate seeking much-needed mental health services can be an outcome when images of treatment repeatedly portray incompetent, bumbling, indifferent, and/or nefarious providers.
In contrast to my common reactions of frustration and embarrassment to cinematic depictions of therapy, the recent film You Hurt My Feelings left me reassured. In the film, Tobias Menzies plays Don, a therapist working with a multitude of patients while simultaneously managing his own abrupt marital crisis manifesting after his wife (played by Julia Louis-Dreyfus) overhears a conversation about his dislike of her new book. The film asks when it is okay to lie in a relationship and explores the nebulous border between dishonesty and support. Should Don be honest about his feelings or instead continue to encourage his wife's involvement in a writing project he does not believe is quality work?
Throughout You Hurt My Feelings, Don is a caring, compassionate, and of critical importance, imperfect professional. In one uncomfortable scene, he confuses one patient’s history for that of another. This elicited laughter from the audience in attendance, but based on my personal experiences as well as my training and supervision of clinicians, I understand the reality of this scenario. Therapists, counselors, and psychologists occasionally confuse patients' backgrounds, become bored in sessions, and zone out. Sometimes they are not at their best (e.g., their own newborn child kept them awake all night). Also, strikingly realistic in this scene is the response of the patient: “That’s alright. I know you see a lot of patients.” Patients rarely become angry or annoyed about these incidents when they are acknowledged by the professional and followed by a sincere apology.
You Hurt My Feelings depicts other realistic clinical scenarios, such as patients asking personal questions or demonstrating passive-aggressive behavior; to each, Don’s responses are clinically appropriate. However, his involvement with a bickering couple he has been working with for two years is misleading and unfortunately miseducates about the therapy process. The couple questions why they are paying Don to simply engage in the same behavior in the office as they do at home. This is indeed a legitimate query. Don’s response is an anodyne “therapy can be a long-term process” after which he passively returns to observing their mean and abusive interactions. In reality, couple’s therapy tends to be direct, interactive and skill-based, such as the extremely efficacious emotion focused therapy approach. While therapy can indeed be a long-term process, an honest conversation is long past due if a professional has been working with a client for two years with no progress, growth, or at least a reduction in symptoms. It is no wonder the couple in the film angrily drops out of treatment and demands reimbursement for two years’ worth of session payments.
In spite of its flaws, You Hurt My Feelings presents us with the most realistic depiction of therapy thus far in 2023. Contrast it to Stephen Henderson’s portrayal of a mental health professional in the recent Beau is Afraid, who is secretly recording sessions and selling them to the eponymous character’s mother to assist in her manipulation and domination of him.
In both his marriage and treatment practice, Don evolves and learns it is sometimes better to be honest and direct in addition to supportive and encouraging. Professional mental health workers challenge their clients to grow, but simultaneously the latter can unknowingly promote the growth of professionals.